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Childhood Asthma Varies by Neighborhood

February 19, 2008 | by Marla Paul
CHICAGO --- Asthma is the most prevalent chronic disease of childhood in the United States, with an estimated 8.9 million children affected. Childhood asthma prevalence is at a historic high, with the disparity between Black and White children increasing. Moreover, childhood asthma prevalence has been shown to be higher in urban communities overall without an understanding of differences by neighborhood.

Chicago has one of the highest asthma mortality rates in the United States, and studies have shown poor outcomes with respect to asthma-related illness and death and socioeconomic and racial status.

A new study led by Ruchi Gupta, M.D., M.P.H., a researcher at Children's Memorial Research Center and associate professor of pediatrics at Northwestern University Feinberg School of Medicine, and colleagues found that while overall asthma prevalence in Chicago was 12.9 percent, rates varied from nearly zero percent to 44 percent depending on the child's neighborhood.

The study was published in the Feb. 7 online issue of The Journal of Allergy and Clinical Immunology and will appear in the March 2008 print version as an Editor's Choice article.

Gupta and colleagues analyzed the asthma status of nearly 49,000 Chicago school children and characterized the results by Chicago neighborhoods. The study was conducted as part of the Chicago Initiative to Raise Asthma Health Equity, which is supported by grants from the National Heart, Lung, and Blood Institute.

The researchers showed that childhood asthma rates in predominantly Black neighborhoods varied from 4 percent to 44 percent; in predominantly White neighborhoods, the rates varied from 2 percent to 30 percent; and in predominantly Hispanic neighborhoods, the rates varied from zero percent to 29 percent.

"Our data suggest that although overall asthma prevalence is higher in Black than White children in an urban setting, a significant indicator of asthma prevalence is the neighborhood and community in which a child lives," Gupta said.

"One neighborhood may have less than 5 percent of its children diagnosed with asthma, while the next neighborhood over has 30 percent of its children diagnosed with asthma. It is important to understand what is causing such differences in childhood asthma rates by neighborhood," she said.

Although gender, age, household members with asthma and neighborhood income significantly affect asthma prevalence, these factors did not explain the differences seen between neighborhoods. Race/ethnicity explained a significant proportion but not all of the neighborhood variation, the study showed.

The researchers called for a better understanding of potentially unexplored neighborhood and community factors related to asthma prevalence and differences in prevalence seen across neighborhood.

"This is an essential step to understanding the true cause of and preventing any future increase in childhood asthma," they stated.
Topics: Research